PETERKIN & ASSOCIATES, INC. (NPI# 1346370459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346370459 |
| Entity Type | Organization |
| Organization Name | PETERKIN & ASSOCIATES, INC. |
| Practice Address |
7559 Decatur Dr Fayetteville NC 28303-1989 |
| Mailing Address |
131 Hay St Ste 201 Fayetteville NC 28301-5649 |
| Practice Telephone | 9104841869 |
| Practice Fax Number | 9104838515 |
| Mailing Telephone | 9103231817 |
| Mailing Fax Number | 9103232607 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2012-01-11 |
| Authorized Official Name | MRS. ALICE SMITH (CEO) |
| Authorized Official Telephone | 9103231817 |
| Authorized Official Credential | ED.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | MHL-026-097 | NC | Nursing & Custodial Care Facilities |
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | MHL-026-097 | NC | Nursing & Custodial Care Facilities |
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL-026-097 | NC | Residential Treatment Facilities |
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | MHL-026-097 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 340602E | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932413457 | Peterkin & Associates, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2692 Harris Street, East Point, GA 30344-2672 | 2010-07-27 |
| 1083733323 | Peterkin & Associates, Inc. | Clinic/Center | 203 N William St, Goldsboro, NC 27530-3757 | 2007-03-28 |
| 1740310978 | Peterkin & Associates, Inc. | Assisted Living Facility | 235 Kinlaw Rd, Fayetteville, NC 28311-1431 | 2007-03-06 |
| 1629108097 | Peterkin & Associates, Inc. | Assisted Living Facility | 6214 Kilmory Dr, Fayetteville, NC 28304-2724 | 2007-03-06 |
| 1508996059 | Peterkin & Associates, Inc. | Assisted Living Facility | 114 Greenhouse Ln, Southern Pines, NC 28387-3140 | 2007-03-06 |
| 1457481988 | Peterkin & Associates, Inc. | Assisted Living Facility | 1112 Devonshire Trl, Aberdeen, NC 28315-3910 | 2007-03-06 |
| Street Address |
7559 DECATUR DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-1989 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083056782 | Mid-state Health Systems, Inc | Intermediate Care Facility, Mentally Retarded | 7559 Decatur Dr, Fayetteville, NC 28303-1989 | 2013-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1154835577 | Jessica Bass Bosworth | Psychologist | 3415 Youngstown Dr, Fayetteville, NC 28303 | 2017-11-21 |
| Find all providers in zip 28303 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609299916 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 1802 Strickland Bridge Rd, Fayetteville, NC 28304-5739 | 2014-01-23 |
| 1255574034 | Greater Image Healthcare, Corp | Intermediate Care Facility, Mentally Retarded | 401 Roberson Street, Fayetteville, NC 28301-5423 | 2009-04-09 |
| 1487799151 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 2001 Southern Ave, Fayetteville, NC 28306-1757 | 2007-02-21 |
| 1467597708 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 1818 Strickland Bridge Rd, Fayetteville, NC 28304-5739 | 2007-02-21 |
| 1912042797 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 800 Old Wilmington Rd, Fayetteville, NC 28301-6210 | 2007-02-20 |
| 1740337757 | Davis & Associates, Inc | Intermediate Care Facility, Mentally Retarded | 1108 Quailmeadow Dr, Fayetteville, NC 28314-5936 | 2007-01-04 |
| 1699850891 | Sophia B Pierce & Associates Inc | Intermediate Care Facility, Mentally Retarded | 3301 Barksdale Road, Fayetteville, NC 28301 | 2006-10-26 |
| 1477634319 | Mid-state Health Systems, Inc | Intermediate Care Facility, Mentally Retarded | 4309 N.c. Hwy 87 S, Fayetteville, NC 28306-9818 | 2006-10-18 |
| 1023450723 | Mid-state Health Systems, Inc | Intermediate Care Facility, Mentally Retarded | 1050 Hogan St, Fayetteville, NC 28311-2340 | 2013-07-23 |
| 1083056782 | Mid-state Health Systems, Inc | Intermediate Care Facility, Mentally Retarded | 7559 Decatur Dr, Fayetteville, NC 28303-1989 | 2013-07-23 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.